Out here in the real world, researchers understand that so-called negative results can be just as helpful as positive results.
For example, a positive result can look like this:
Drug X is more effective than a sugar pill when it comes to treating the symptoms of major depression.
A negative result, in contrast, might read like this:
Drug Y is no more effective than a sugar pill when it comes to treating the symptoms of depression.
For a scientist, both results are important and useful.
Because marketing and science are two very different things, companies which are interested in maximizing sales are likely to emphasize positive results while attempting to bury negative results.
It turns out that is exactly what is happening.
The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.
Previous research had found a similar bias toward reporting positive results for a variety of medications; and many researchers have questioned the reported effectiveness of antidepressants. But the new analysis, reviewing data from 74 trials involving 12 drugs, is the most thorough to date. And it documents a large difference: while 94 percent of the positive studies found their way into print, just 14 percent of those with disappointing or uncertain results did.
Some people believe that the market and market mechanisms are the key to solving our shared health care crisis.
A market system has powerful built in incentives which value sales over science. If we have learned one thing over the past century it is that the careful, skillful and unbiased application of science to the problem of human disease and suffering is powerfully effective.
This powerful historic insight is undermined whenever and wherever marketing is given dominion over the unbiased application of clinical research.